Gap Formation During Cyclic Testing of Flexor Tendon Repair

2018 ◽  
Vol 43 (6) ◽  
pp. 570.e1-570.e8 ◽  
Author(s):  
Lasse Linnanmäki ◽  
Harry Göransson ◽  
Jouni Havulinna ◽  
Petteri Sippola ◽  
Teemu Karjalainen ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Cyclic Testing ◽  
Gap Formation ◽  
Flexor Tendon Repair

A cyclic testing comparison of two flexor tendon repairs: asymmetric and modified Lim-Tsai techniques

2018 ◽  
Vol 43 (5) ◽  
pp. 494-498 ◽  
Author(s):  
Rebecca Q. R. Lim ◽  
Yoke-Rung Wong ◽  
Austin M. K. Loke ◽  
Shian-Chao Tay
Keyword(s):  
Cyclic Load ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Stage I ◽  
Stage Ii ◽  
Cyclic Testing ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
The Mean

This study compared the biomechanical performance of a novel 6-strand asymmetric flexor tendon repair with the modified Lim-Tsai technique using cyclic testing. Two groups of ten porcine tendons each were repaired and tested. Gap formation at every 100 cycles was measured. Survival was defined as maximum gap formation below 2 mm. All the repairs survived Stage I. With increased cyclic load in Stage II, the mean gap formation of modified Lim-Tsai repairs exceeded 2 mm at the 600th cycle and reached 4.2 mm (SD 1.93) at the end of Stage II, resulting in 0% survival. The mean gap formation of asymmetric repairs reached 2.0 mm (SD 1.43) at the 800th cycle and was 2.4 mm (SD 1.52) at the end of Stage II, with 60% survival. The asymmetric repair has better biomechanical performance under cyclic testing as compared with the modified Lim-Tsai repair.

Cyclic Testing of the 6-Strand Tang and Modified Lim-Tsai Flexor Tendon Repair Techniques

2018 ◽  
Vol 43 (3) ◽  
pp. 285.e1-285.e6 ◽  
Author(s):  
Gavrielle Hui-Ying Kang ◽  
Yoke-Rung Wong ◽  
Rebecca Qian-Ru Lim ◽  
Austin Mun-Kitt Loke ◽  
Shian-Chao Tay
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Cyclic Testing ◽  
Flexor Tendon Repair ◽  
Repair Techniques

Primary Repair Of Flexor Tendons In The Hand Without Immobilisation – Preliminary Report

HAND ◽  
1978 ◽  
Vol os-10 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Hilton Becker
Keyword(s):  
Blood Supply ◽  
Preliminary Report ◽  
Suture Material ◽  
Flexor Tendon ◽  
Primary Repair ◽  
Tendon Repair ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
New Approach ◽  
Flexor Tendons

summary A new approach to the problem of flexor tendon repair within the fibro-osseous canal is presented. Using a technique of bevelling the tendon ends and suturing with a fine suture material, under magnification, a sufficiently strong junction is obtained, which enables immediate active mobilisation without strangulation of the blood supply. The junction can resist gap formation up to tensions of 4 Kg. It is postulated that under these conditions tendon nutrition is minimally interfered with, adhesions do not form, and the tendon heals by its own intrinsic healing ability.

Comparison of Postoperative Early Active Mobilization and Immobilization in Vivo Utilising a Four-Strand Flexor Tendon Repair

2001 ◽  
Vol 26 (4) ◽  
pp. 301-306 ◽  
Author(s):  
A. WADA ◽  
H. KUBOTA ◽  
K. MIYANISHI ◽  
H. HATANAKA ◽  
H. MIURA ◽  
...  
Keyword(s):  
Ultimate Strength ◽  
Flexor Tendon ◽  
Testing Machine ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
Tensile Testing Machine ◽  
Active Mobilization

We evaluated a technique of four-strand double-modified locking Kessler flexor tendon repair in healing tendons. Seventy-two canine flexor digitorum profundus tendons in Zone 2 were repaired and evaluated following either active mobilization or immobilization at 0, 7, 14, 28 and 42 days after surgery. Fifty-six tendons were examined for gap and ultimate strength using a tensile testing machine and 16 were evaluated with standard hematoxylin and eosin, and Masson’s trichrome staining. All tendons healed without rupture or gap formation of more than 1 mm, thus demonstrating that this repair technique has enough tensile strength to withstand early active mobilization. The gap and ultimate strength of actively mobilized tendons did not decrease significantly during the first 7 days, and were significantly greater than those of immobilized tendons throughout the 42-day study period. Actively mobilized tendons healed without the extrinsic adhesions and large tendon calluses that were found in immobilized tendons.

scholarly journals The Effect of Suture Preloading on the Force to Failure and Gap Formation After Flexor Tendon Repair

2013 ◽  
Vol 38 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Matthias Vanhees ◽  
Andrew R. Thoreson ◽  
Dirk R. Larson ◽  
Peter C. Amadio ◽  
Kai-Nan An ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Gap Formation ◽  
Flexor Tendon Repair

scholarly journals Biomechanical study of a newly developed continuous double knots technique compared with the 4-strand double-modified Kessler technique for flexor tendon repair

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Sunton Wongsiri ◽  
Wongthawat Liawrungrueang
Keyword(s):  
Tensile Strength ◽  
Failure Load ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Biomechanical Properties ◽  
Suture Technique ◽  
Cyclic Testing ◽  
Flexor Tendon Repair ◽  
Ultimate Failure Load ◽  
Ultimate Failure

Abstract Purpose In this study we compare the biomechanical properties of a novel suture technique that we developed called the continuous double knots technique for repairing flexor tendon injuries with the standard 4-strand double-modified Kessler technique. Methods This was an experimental study. Eighty porcine flexor digitorum profundus tendons were harvested and divided randomly into two groups of 40. The first group (N = 40) was repaired using the 4-strand double modified Kessler technique and the second group (N = 40) was repaired using our new continuous double knots technique. The two groups were randomly divided and the ultimate failure load (n = 20) and cyclic testing to failure (n = 20) were compared. Results The mean ultimate failure load was 25.90 ± 7.11 (N) and cyclic testing to failure 88 ± 47.87 (cycles) for the 4-strand double modified Kessler technique and 34.56 ± 6.60 (N) and 189 ± 66.36 (cycles) for our new continuous double knots technique. The T-test revealed a significant difference between the 2 techniques (p < 0.05). In terms of biomechanical properties in tendon repair, the continuous double knots technique group had a higher tensile strength than the 4-strand double-modified Kessler technique group. There were also significant differences between the ultimate failure load and cyclic testing to failure for the flexor tendon sutures. Conclusions The continuous double knots technique suture technique had significantly higher maximum tensile strength and cyclic testing than the 4-strand double modified Kessler technique in an in vitro study, and in thus an optional technique for flexor tendon repair.

Biomechanical Analysis of a Step-Cut Technique for Flexor Tendon Repair

1992 ◽  
Vol 17 (3) ◽  
pp. 282-285 ◽  
Author(s):  
L. GORDON ◽  
J. L. GARRISON ◽  
J. C. CHENG ◽  
Y. K. LIU ◽  
R. P. NATHAN ◽  
...  
Keyword(s):  
Tensile Strength ◽  
Ultimate Tensile Strength ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Biomechanical Analysis ◽  
Flexor Digitorum Profundus ◽  
Gap Formation ◽  
Flexor Tendon Repair ◽  
The Core ◽  
Human Cadavers

We compared the strength of a new step-cut technique for flexor tendon repair with that of the widely used Kessler-Tajima technique, giving special attention to the relative contributions of the core and epitendinous sutures. 36 flexor digitorum profundus tendons from human cadavers were used. Corresponding digits from the same donor were paired, and the two tendons of each pair were placed in the Kessler-Tajima and step-cut groups, respectively. Each group had three subcategories of repair: (1) core repair alone; (2) epitendinous repair alone; and (3) full repair. In the Kessler-Tajima repair, the core stitch contributed more to ultimate tensile strength, while the epitendinous stitch contributed more to gap formation resistance. In the step-cut repair, however, the epitendinous stitch contributed more to both measures of strength. The full step-cut repair was 65% stronger in resisting gap formation and had 84% more ultimate tensile strength than the full Kessler-Tajima repair. We attribute the greater strength of the step-cut repair to the additional number of epitendinous loops, which lie perpendicular to the long axis of the tendon.

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